Authorized Authorized

DELIVERING SERVICES
157
Table 3.1 The impact of digital technology on government capability to deliver
services: A scorecard
Channel
Impact of
technology
Main problem
to address
Do digital technologies solve the problem?
Informing citizens
and giving them
an identity
H
Poor information
and communication
• Yes, when poor information is the main barrier to
improving service outcomes
Streamlining
processes
M
High transaction
costs; rent-seeking
• Sometimes, given the considerable heterogeneity
of impacts across countries and the high risks and
rewards of reforms
Receiving user
feedback
M
High transaction
costs; rent-seeking
• Yes, when citizens have an incentive to complain
and services can be easily monitored
• No, otherwise
Improving
service provider
management
L
Information
asymmetries
• Yes, for reducing ghost workers and absenteeism
• No, for improving provider accountability for
services that cannot be easily monitored
Source: WDR 2016 team.
Note: Channels are arranged by degree of technology impact. L = low; M = medium; H = high.
communication—citizens’ lack of knowledge about
issues that affect their welfare, their inability to communicate
with one another and with government,
and government’s inability to be informed about
citizens. For example, the provision of information
to citizens, particularly to poor citizens in remote
locations through mobile phones, has helped people
make better decisions on a variety of issues. And digital
identification, by giving poor citizens a verifiable
identity, has enabled them to participate in public and
private services previously denied to them.
Digital technologies have been less effective in
solving government failures associated with rentseeking
and in strengthening the incentives of government
bureaucrats and service providers to perform
due to principal-agent problems associated with
information asymmetries. Automating government
functions and services has been at best partially successful;
these are often complex and costly systems to
implement. The failure rate is high, and so is the risk
of wasting public funds. Citizen feedback has been
effective when citizens have an incentive to provide
feedback and the services are fairly easy to monitor,
and when governments have the capacity to respond
to this feedback. It is not effective when these conditions
are absent. Aside from a few isolated examples
of reducing absenteeism, digital technologies have
not significantly improved service provider management
in government bureaucracies.
Informing citizens and giving them an
identity
Digital technologies are enabling governments to
overcome barriers of geography, low physical connectivity,
and limited administrative capacity to provide
information and deliver services to previously
unreached citizens, improving citizen participation
and choice. The most popular and promising innovations
in poor countries entail the use of mobile
phones to implement a variety of health interventions—so-called
“m-health” (mobile health) initiatives.
These can focus on either health providers, such as
point-of-service data collection, disease surveillance,
health-promotion campaigns, and telemedicine; or
on citizens, such as SMS reminders to parents to get
children vaccinated or to patients to undertake therapy
(sector focus 3). While hundreds of pilot m-health
initiatives are underway, robust evidence in developing
country contexts is limited largely to the positive
effects of reminding patients to adhere to their
antiretroviral therapy schedules. 6 Initial results from
pilots in Bangladesh, India, South Africa, and Tanzania
suggest that regular SMS communication can
induce similar behavior changes in expectant mothers
by providing information on neonatal health. 7
The initial results are also promising from m-health
initiatives that assist health providers in recording
patient information, monitoring pregnancies, and
reporting drug stock-outs. 8